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APPROVALS DATE ID/SIG.
<br />Appliances
<br />Metal Fire Place
<br />Evaporative Cooler
<br />Furnace
<br />Compressor
<br />Ivlisc. Equipment
<br />Duct Work
<br />Pre-lnsulation
<br />lnsulation
<br />Smoke Detectors lnstalled
<br />Rough Ductwork
<br />Vents
<br />Igilet Room / Clothes Dryer s-z[-/r tr.Wjol
<br />Residential Range
<br />Other
<br />Hood
<br />Type I Hood
<br />Type ll Hood
<br />Grease Duct
<br />Fire Damper
<br />Openings
<br />lnstallation
<br />F.D. Drop Test
<br />Above Hard Lid
<br />Rough Mech.
<br />Final Test
<br />Meter Release A
<br />FINAL r.ro,tb z 7t*+t ,3<!
<br />Notes, Remarks, Etc.
<br />MECHANICAL.INSPECTOR RECORD
<br />OT NEA AUILDER DEL(NRATION
<br />I hcrcby lmrn lndd I'cnlhy of l,cr.iury rhlr I m .r.n$ frcnr thc Conrr..lm Lian* L!* for rlE followitrB M$i (S...7011t
<br />Busimr! un<! Piolcsion Codc): Ary Ciry or Colnry whi.h rcquircs ! rEmit lo consrtu r. 8lrd, in\mw. &elirh or qun dy
<br />slruclw. prbr b ns hsu cc, rl$ rcqunca lhc agpli.rir lor iuch pcrnir ro nh r sigGd sr,lcmnt $ai lE or sh. b lirnpd pursuui
<br />ro lhe rotisions of r C.nra.rois Liccnsd lr{ tchErcr 9, Commncins snh Sedion 7000 of Dilisioo I of rhc Burincsr and
<br />Pmlcasions Codc) o. rhll lr or *hc ii .x.q,t ftcdbn x.d rhc t{sis for rh4 lllcged crcmflion. An, violflioo ot s.oh. 70l l.5 by.ry
<br />appliclnl ior !pcrnil subj.rls llE rrpli.antlorcivilp.naltyofnormr.lh fiv. hundEd doller (3500).
<br />-1.
<br />&\ ownr or ttE piDpcny. o, n, cr{rlorrcs wnh wag.s &i rlEn eb comFBdion, wiu .lo the w6t aid dE surEiw i! ml
<br />intcndcd or ofie6d for eh (5(.7044. Blsimss and Pmfc$ions Codc TIE ConlEcltr's Li..nsc l,w docs nol al,ply to an owr of
<br />ltu pmpny who blilti or iiy'mks tlE6n, 3d who &Es rch slk himsclf or hs*laor $eugh hh or h$ ow. enplorrB,
<br />trovidcd thar slch impmwnls m ml inrcn&d trofrd.d ror sh It how.B.lhe hoildin8 or i,pmwEnl h sld *idin orc }le
<br />ofcoophio[ rlE Oee, 8!ild6 will haw 0E h!ib. 6f Flving rhd lE oBlE dij m| taild or h!rcr [E pFtfiy lo dE p!4b* ol
<br />-1,
<br />{sowffiofih. pmFnr. m.rclusivcly.onr&ring sirh lian*d.onraro6 ro onnod E,rej.cl (Se.7014, Burirc$
<br />and hnfssi.n Codc: ThcConx&roas Li.cnrc Ii{ dGs ror apllyro an osn6 ofpropcdywno buildsor imporc. rh(co..
<br />snd who onhcls aor such pmicls wilh r Conlfldons) Iftnsc{ l)unulnl to lhe Conhctol! Lims trw)
<br />uof,f,E8s:cQMPjlsarlott
<br />PECI,TAAIIIIN
<br />I hcrcby aftirm undcr pctr.lty.l pcrjury orc orlhc folbwi,E delarclions:
<br />l-rhtr ( dlc, nrrhc t^-rhirnnic. of rhc sork nn trhirh rhc lcnnn i\ t\ucJ
<br />-l
<br />bavcund will m,inluin worlc6 conlpcn\lriniasu,ah-^c.rs,cquns]sySdion:l7ll()orrhcl,b.rCodc,forrhcttjrrormnccot
<br />rhr Norl ro *hictliispcrmir is isled niy sorkcs @hpenqtion irsuruncc cnrtr and Plicy huohc. dc:
<br />I,(,li.y Nur$cr: Exp
<br />_l ccniti rhnr in rlE Frforturc. orth. work for whici rtis pcrmir is h$cd. I rhall nor.rq,loydny I'cr$! i. an, mntr
<br />v, &s lo txsB suhtrl lo lrE wo*s{ ohl,.nelhn lavs or Calilomi!, lnd .88 rh.t if I slnuld tEcom sobrcl lo lL
<br />wo*cr'omtcnsolionl,ovisioNofSclionlT00ofth.tjtxrCod!,lslEll.fodhwnhomplywhhlhspmvisions..
<br />WARNINC. F0ilu,c r. surc *itrkc* .o'rycniiri(,n covcogc i\ tnla*tu1. md shrlr \ub,*r nn .nrplo)$ ro nlnriml !...lths and
<br />.ivil fi cs ut ro oM hurdrcd rhouqnd dolh^ ($l(x),Ixx]) ir/.i{ilr,n h, rhc (,N or..nrFnqrr'nn, driugcs n\ noridcd ior lhc
<br />:.:::,,^'i{fi" i ?-
<br />*
<br />"
<br />*^;::,, *{.v1 / {#
<br />,,a* n,rtir a,rnr*a'r,r* '
<br />DECLAA.A.IIO
<br />or rh. h'\i',cs r Pdus\tnrcodc. nnJ trrv lic.n\c i\ i'r hlll,r(c rn.lrrricr
<br />,r", (
<br />ralslf,lEllaN.LljlDlx(i-a{i.ENcr
<br />lltrbyrllirmund.rp.n,lryufFrjuryth.'rhLrci\r.uniru.rtunkndingdSctuyrorrhcprrfomsnccoflhcsortntrshichlhta.oiris
<br />i(sr.d lsc. :1(197, Civ. C )
<br />A8I].ICANLDEII,AEAIIAN
<br />Ilxrhy nmuMcrpctr!hyolpcrjuryon.otlhclollowirSd(lamrions:
<br />Dcmnili,'n Pcrmils A\lE(os NorifEation LdcrnlRcEulation\ (.| nlc 40. Pfi6)
<br />-R.quncd
<br />ktrc. rt N.tiftrlrion
<br />I.cnifyrlrarrhrlidcfulREuLrnrNNgrdin8Nh.iosrcnxrMlrrc iorloplicibl.brhi\fl,1..r
<br />_l ccnily Ihat I holc rcad rhh alplication srrl srorc rhot rhc dnlc inrbrnmrion h cord.I aeN rocomplyqirh rll Ciry anrl Coun'y
<br />o^linln .s a.d srarc kw. Ehrin! ro bu
<br />ohov.
<br />'mntiomd
<br />pmlcny lo. irsF.lion
<br />Apt'li.unt o. AE€nl SiBnrlu,c K
<br />r.soflhisCily d Cou y lo .nl6 upon dE
<br />_^,", {/-,(rtr
<br />COMMENTS
<br />Above T-Bar
<br />I lmcicmDt undcr S(uon .8 &PC lorrhhEa{n.
<br />D.le Orn.r:
<br />"-**".(
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